MEDICARE: SUSAN RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS32279	FL

General Provider Information

NPI Number	:	1326431800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN RODRIGUEZ

Provider Business Mailing Address
First Line	:	3260 DAVIE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2766
Country	:	US
Telephone Number	:	954-587-3126
Fax Number	:

Provider Business Practice Location Address
First Line	:	3260 DAVIE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2766
Country	:	US
Telephone Number	:	954-587-3126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

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Directions to “ SUSAN RODRIGUEZ ” Practice Location

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